Ecthyma gangrenosum as a very early herald of acute lymphoblastic leukaemia

Ecthyma gangrenosum is a manifestation of cutaneous infection by Pseudomona s aeruginosa. The lesion may be associated with immunocompromise, in partic ular neutropenia. We present a case of ecthyma gangrenosum in a previously healthy child who 3 months later developed acute lymphoblastic leukaemia; w e use this to illustrate the lack of information on the growth rate of mali gnant and premalignant leukaemic cells in children.